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Hawaii rates for HCPCS L5961

Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,922.45 / $2,922.45 / $2,922.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,186.87 / $5,186.87 / $5,186.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,728.42 / $3,728.42 / $7,182.12
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,540.89 / $1,540.89 / $1,540.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,570.43 / $6,529.20 / $9,140.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,677.20 / $6,104.80 / $7,182.12
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,259.51 / $5,439.76 / $6,214.59